Does perioral dermatitis go away?

How long does it take to clear?

With treatment, the rash usually clears within several weeks, but the prescribed antibiotic course often lasts 2 to 3 months. Improvement and finishing treatment are different milestones. Some cases need a longer course, so follow the prescribed plan rather than stopping as soon as the bumps look better.1

Why can it get worse before it gets better?

Stopping a steroid cream can cause a temporary flare before the rash improves. Do not restart the cream unless your clinician tells you to. If the steroid was prescribed, ask how to stop it; your clinician can decide whether a gradual withdrawal using a weaker cream is appropriate. Discuss prescribed steroid inhalers, nasal sprays or tablets with the prescriber rather than stopping them yourself.345

What should you do now?

1. 1Arrange a medical appointment if bumps around your mouth do not go away. Perioral dermatitis can resemble acne or rosacea, and treatment starts with identifying the rash.
2. 2Review facial products and steroid use with your clinician. Stop face creams and cosmetics unless your clinician advises otherwise, and avoid using an over the counter steroid cream to treat the rash.
3. 3Wash with warm water only while the rash is active, and do not pick or squeeze the bumps.
4. 4Use any prescribed treatment as directed. Mild cases can respond to medication applied to the skin; more severe cases can need antibiotic tablets.

Reducing the products on your face is the point, so a new collection of 'minimalist' skincare rather misses the assignment.2

Skin treatments include metronidazole, erythromycin and pimecrolimus. Oral antibiotics such as doxycycline help reduce inflammation. Pregnancy changes medication choices: oral erythromycin is one option a clinician can consider during pregnancy. Do not choose an antibiotic or treatment strength yourself.13

Will it come back?

Most cases do not return after treatment, but recurrence is possible, particularly if steroid creams are used on the face again. Long periods without symptoms are possible. After clearing, ask about a soap substitute or gentle liquid cleanser; an unperfumed moisturiser can help if your skin is dry or sensitive.14

A gentle cleanser is a practical choice, not the opening vacancy for an entire bathroom shelf.4

Does it go away in children?

In children, periorificial dermatitis often starts improving spontaneously within 2 to 3 weeks, though full clearance can take months. Mild cases treated with topical antibiotics typically clear in 3 to 8 weeks. The bumps usually heal without scars, but changes in skin colour can remain. Treatment choices differ from adults: oral tetracyclines should be avoided in children under 12.5

When should you see a dermatologist?

Seek dermatology help if the rash persists after stopping facial steroid creams. If you develop conjunctivitis, meaning pink eye, tell your clinician; an eye specialist referral can be needed. Different forms of dermatitis can look similar, and a treatment for one condition need not work for another.36

Does seborrheic dermatitis go away?

Seborrheic dermatitis is a different condition, causing a scaly rash on areas such as the scalp and face. In babies, cradle cap usually disappears on its own within a few months. In teenagers and adults, seborrheic dermatitis can disappear without treatment or continue for life with recurring flares. There is no cure, but treatment can reduce itching and sometimes clear the rash.7